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General NPI Number Information
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NPI Number | 1285618579
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Entity Type | Individual
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Provider Name | RAJESH AGARWAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 6770 MAYFIELD RD SUITE 425
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-2299
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Country | US
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Telephone | 440-312-9041
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Fax | 440-882-3953
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Provider Business Mailing Address
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Address Line | 3940 WATERFORD CT
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City | BEACHWOOD
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State | OH
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Zip | 44122-4743
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Country | US
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Telephone | 440-346-4427
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Fax | 440-882-3953
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D73575
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License Number State | OH
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